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首页> 外文期刊>Clinical and diagnostic laboratory immunology >Tuberculin Skin Testing Compared with T-Cell Responses to Mycobacterium tuberculosis-Specific and Nonspecific Antigens for Detection of Latent Infection in Persons with Recent Tuberculosis Contact
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Tuberculin Skin Testing Compared with T-Cell Responses to Mycobacterium tuberculosis-Specific and Nonspecific Antigens for Detection of Latent Infection in Persons with Recent Tuberculosis Contact

机译:结核菌素皮肤测试与结核分枝杆菌特异性和非特异性抗原的T细胞反应相比,可检测新近接触结核病患者的潜伏感染

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The tuberculin skin test (TST) is used for the identification of latent tuberculosis (TB) infection (LTBI) but lacks specificity inMycobacterium bovis BCG-vaccinated individuals, who constitute an increasing proportion of TB patients and their contacts from regions where TB is endemic. In previous studies, T-cell responses to ESAT-6 and CFP-10, M. tuberculosis-specific antigens that are absent from BCG, were sensitive and specific for detection of active TB. We studied 44 close contacts of a patient with smear-positive pulmonary TB and compared the standard screening procedure for LTBI by TST or chest radiographs with T-cell responses toM. tuberculosis-specific and nonspecific antigens. Peripheral blood mononuclear cells were cocultured with ESAT-6, CFP-10, TB10.4 (each as recombinant antigen and as a mixture of overlapping synthetic peptides), M. tuberculosis sonicate, purified protein derivative (PPD), and short-term culture filtrate, using gamma interferon production as the response measure. LTBI screening was by TST in 36 participants and by chest radiographs in 8 persons. Nineteen contacts were categorized as TST negative, 12 were categorized as TST positive, and 5 had indeterminate TST results. Recombinant antigens and peptide mixtures gave similar results. Responses to TB10.4 were neither sensitive nor specific for LTBI. T-cell responses to ESAT-6 and CFP-10 were less sensitive for detection of LTBI than those to PPD (67 versus 100%) but considerably more specific (100 versus 72%). The specificity of the TST or in vitro responses to PPD will be even less when the proportion of BCG-vaccinated persons among TB contacts evaluated for LTBI increases.
机译:结核菌素皮肤试验(TST)用于鉴定潜伏性结核(TB)感染(LTBI),但在接种牛分枝杆菌BCG的个体中缺乏特异性,这在结核病患者及其患者中所占比例越来越高结核病流行地区的接触者。在以前的研究中,T细胞对ESAT-6和CFP-10, M的反应。卡介苗缺乏的结核特异性抗原对活动性结核病的检测具有敏感性和特异性。我们研究了44名涂片阳性肺结核患者的密切接触者,并比较了通过TST或胸部X线照片对LTBI进行标准筛查的程序,以及T细胞对M的反应。结核病和非特异性抗原。外周血单核细胞与ESAT-6,CFP-10,TB10.4(分别作为重组抗原和重叠的合成肽的混合物),M共培养。以γ-干扰素的产生作为应对措施,对结核菌进行超声处理,纯化蛋白衍生物(PPD)和短期培养滤液。 TST在36名参与者中进行了LTBI筛查,在8人中进行了胸部X光片检查。 19位联系人被归类为TST阴性,12位被归类为TST阳性,5位具有不确定的TST结果。重组抗原和肽混合物给出了相似的结果。对TB10.4的反应对LTBI既不敏感也不特定。 T细胞对ESAT-6和CFP-10的反应对LTBI的检测不如对PPD敏感(67对100%),但特异性更高(100对72%)。当针对LTBI评估的结核病接触者中接种BCG疫苗的人员比例增加时,TST的特异性或对PPD的体外反应甚至更低。

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